Eating disorder not otherwise specified (EDNOS)

refers to forms of disordered eating that may not exactly fit into the main classifications of eating disorders, but are associated with binging or purging behaviours, frequent dieting, obsessive thoughts about food, negative body image, or over-exercising. Treatment will vary depending on the symptoms of each individual. One of the main conditions within the EDNOS category is binge eating disorder.

What is binge eating disorder?

Binge eating disorder involves frequent bingeing episodes that a person feels they cannot control. Contrary to people with bulimia, people with binge eating disorder do not use compensatory mechanisms to get rid of the calories. This may result in considerable weight gain. People with binge eating disorder typically eat normally around others but may be hiding or stockpiling food to eat later in secret. They may also skip regular mealtimes and instead eat continuously throughout the day.

As with bulimia, the food that is eating during a binge is usually high in calories and fat, and the binges are kept secret from others. Vast amounts of food are eaten very quickly, even when a person is not feeling hungry, to the point of feeling painfully full.

A person might feel numb during a binge, like on auto-pilot, yet the binge may lead to an instant surge of pleasure and help vent painful or difficult emotions. Binge eating behaviour is typically followed by strong feelings of shame and self-hatred. As a result, people with binge eating disorder are literally trapped in an isolating cycle of dieting, binging, self-blame and self-hatred.

What are the physical symptoms of binge eating disorder?

Like anorexia or bulimia, binge eating disorder too has a substantial impact on the physical and the emotional health of a person. Health consequences may include gastrointestinal problems, like bloating, stomach cramps, constipation or diarrhoea, gallbladder disease, high blood pressure and high cholesterol levels, heart conditions, diabetes, signs of malnutrition due to the type of foods consumed, and joint and muscle pain.
Most of these symptoms can be reversed once normalised eating habits are established and healthy weight loss is achieved.

People with binge eating disorder have an extremely negative body image. Additionally, depression and anxiety, low self-esteem, feelings of inadequacy and worthlessness are common for binge-eating disorder.

It is important to distinguish between binge eating disorder – a serious mental health condition – and obesity, which is a concept used for weight classification, and can be a symptom of binge eating disorder.

Other types of disordered eating in the EDNOS category are:

People with bulimia typically start their days eating very little and stick to very low calorie meals during the day. This might end in binges at the end of the day, where they consume a large amount of high calorie foods (carbohydrates and fats). Bingeing and purging is done secretly, and bingeing only stops when people are uncomfortable full or are interrupted, leaving them feeling guilty and anxious. Bingeing episodes may be followed by days of strict dieting. People with bulimia often eat normally in the presence of others.

A warning sign for someone to suffer from bulimia may be that the person disappears to the bathroom after meals. They may also secretly hoard food. People with bulimia may be very emotional and suffer from irritability and mood swings. They may have problems dealing with social situations and in their interaction with others.

What are the physical symptoms of bulimia nervosa?

  • Night eating syndrome – characterised by continued late-night bingeing episodes

  • Orthorexia – an unhealthy obsession with healthy eating

  • Compulsive overeating – eating large amounts of food continuously throughout the day, even when not hungry

  • Pica – craving of non-food items, often due to nutritional deficiencies

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